Treatment of Rheumatoid Arthritis in Renal Failure Review
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Treatment of Rheumatoid Arthritis in Renal Failure Review

University of Washington Nephrology Grand Rounds — January 21, 2022

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➡️Kidney failure, also known as end-stage kidney disease, is a medical condition in which the kidneys can no longer adequately filter waste products from the blood, functioning at less than 15% of normal levels. Kidney failure is classified as either acute kidney failure, which develops rapidly and may resolve; and chronic kidney failure, which develops slowly and can often be irreversible. Symptoms may include leg swelling, feeling tired, vomiting, loss of appetite, and confusion. Complications of acute and chronic failure include uremia, high blood potassium, and volume overload. Complications of chronic failure also include heart disease, high blood pressure, and anemia.

Causes of acute kidney failure include low blood pressure, blockage of the urinary tract, certain medications, muscle breakdown, and hemolytic uremic syndrome. Causes of chronic kidney failure include diabetes, high blood pressure, nephrotic syndrome, and polycystic kidney disease. Diagnosis of acute failure is often based on a combination of factors such as decreased urine production or increased serum creatinine. Diagnosis of chronic failure is based on a glomerular filtration rate (GFR) of less than 15 or the need for renal replacement therapy. It is also equivalent to stage 5 chronic kidney disease.

Treatment of acute failure depends on the underlying cause. Treatment of chronic failure may include hemodialysis, peritoneal dialysis, or a kidney transplant. Hemodialysis uses a machine to filter the blood outside the body. In peritoneal dialysis specific fluid is placed into the abdominal cavity and then drained, with this process being repeated multiple times per day. Kidney transplantation involves surgically placing a kidney from someone else and then taking immunosuppressant medication to prevent rejection. Other recommended measures from chronic disease include staying active and specific dietary changes. Depression is also common among patients with kidney failure, and is associated with poor outcomes including higher risk of kidney function decline, hospitalization, and death. A recent PCORI-funded study of patients with kidney failure receiving outpatient hemodialysis found similar effectiveness between nonpharmacological and pharmacological treatments for depression.

In the United States acute failure affects about 3 per 1,000 people a year. Chronic failure affects about 1 in 1,000 people with 3 per 10,000 people newly developing the condition each year. Acute failure is often reversible while chronic failure often is not. With appropriate treatment many with chronic disease can continue working.

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Episode 5: In this episode of Plant-Based Kidney Health, we talk about how diabetes can affect kidney health. We discuss the relationship between diabetes and kidney function, the connection between high blood sugar levels and kidney disease progression, and how to address kidney-related diabetes health risks.

0:00 Intro
3:25 Link between diabetes and kidney disease
4:40 How does sugar damage the kidneys
6:00 Difference between Type vs Type 2 diabetes
8:24 How well controlled should blood sugar be to prevent kidney damage?
11:08 Why does a diabetic diet contradict a renal diet?
14:55 Biggest myths around diabetes and renal diet?
17:08 Complex versus refined carbs and added sugar vs sugar in fruit.
19:45 Insulin resistance and plant-based diets
26:24 Tips and tricks for making the transition to eating more plants in diabetics

Connect with us:

Sean Hashmi, MD, MS, FASN
https://www.SELFPrinciple.org
https://www.instragram.com/seanhashmimd

Michele Crosmer, RD CSR
https://plantbasedkidneys.com/
https://www.instagram.com/plantbased.kidneys/

Disclaimer
The information provided on this channel is for educational purposes only, and does not substitute for professional medical advice. Please consult a medical professional or healthcare provider for medical advice, diagnoses, or treatment.